To mark World AIDS Day 2016, the World Health Organisation (WHO) has released new guidelines on HIV self-testing to improve access to and uptake of HIV diagnosis.

The WHO will be promoting HIV self-testing policies, urging countries and communities to deploy high-impact prevention services and further expand early and quality treatment for all.

While South Africa has adopted the WHO’s ‘Test and Treat’ policy, the National Department of Health (NDoH) still needs to issue guidelines for HIV self-testing, which has been a contentious issue among the South African healthcare community, despite the South African Pharmacy Council (SAPC) approving HIV self-testing kits in May 2015 and them being readily available over the counter in retail pharmacies.

According to a new WHO progress report, lack of an HIV diagnosis is a major obstacle to implementing the Organisation’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART). The WHO recommends that everyone with HIV, regardless of their CD4 cell count, should begin ART treatment as soon as possible.

The report shows that more than 18 million people living with HIV have access to HIV treatment, but many more lack HIV diagnosis and consequently are missing out on treatment.

Today, 40% of all people with HIV (over 14 million) remain unaware of their status. Many of these are people at higher risk of HIV infection who often find it difficult to access existing testing services.

“Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others,” said WHO Director-General, Dr Margaret Chan.

“HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services,” continued Dr Chan.

HIV self-testing is a way to reach more people with undiagnosed HIV and represents a step forward to empower individuals, diagnose people earlier before they become sick, bring services closer to where people live, and create demand for HIV testing, says the WHO.

“By offering HIV self-testing, we can empower people to find out their own HIV status and also to notify their partners and encourage them to get tested as well,” said Director of WHO’s Department of HIV, Dr Gottfried Hirnschall.

“This should lead to more people knowing their status and being able to act upon it. Self-testing will be particularly relevant for those people who may find it difficult to access testing in clinical settings and might prefer self-testing as their method of choice,” continued Dr Hirnschall.

Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that male partners of pregnant women had twice the uptake of HIV testing when offered self-testing compared with standard testing.

The massive expansion of ART has reduced the number of people dying of HIV related causes to approximately 1.1 million in 2015 – 45% fewer than in 2005.

Having achieved the global target of halting and reversing the spread of HIV, world leaders have set the 2020 “Fast-Track” targets to accelerate the HIV response and to END AIDS BY 2030.

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